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The English Language Needs of Nurses in Medical Tourism in Malaysia Aditya Karuthan Faculty of Languages and Linguistics Univers

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The English Language Needs of Nurses in Medical Tourism in Malaysia Aditya Karuthan Faculty of Languages and Linguistics Univers THE ENGLISH LANGUAGE NEEDS OF NURSES IN MEDICAL TOURISM IN MALAYSIA ADITYA KARUTHAN FACULTY OF LANGUAGES AND LINGUISTICS UNIVERSITY OF MALAYA KUALA LUMPUR 2015 i THE ENGLISH LANGUAGE NEEDS OF NURSES IN MEDICAL TOURISM IN MALAYSIA ADITYA KARUTHAN DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTERS OF ENGLISH AS A SECOND LANGUAGE FACULTY OF LANGUAGES AND LINGUISTICS UNIVERSITY OF MALAYA KUALA LUMPUR 2015 ii UNIVERSITY MALAYA ORIGINAL LITERARY WORK DECLARATION Name of Candidate: Aditya Karuthan (I.C/Passport No: 890928-10-5465) Registration/Matric No: TGB120005 Name of Degree: Masters of English As A Second Language Title of Project Paper/Research Report/Dissertation/Thesis (“this Work”) THE ENGLISH LANGUAGE NEEDS OF NURSES IN MEDICAL TOURISM IN MALAYSIA Field of Study: I do solemnly and sincerely declare that: (1) I am the sole author/writer of this work; (2) This Work is original; (3) Any use of any work in which copyright exist was done by way of fair dealing and for permitted purposes and any extract from, of reference to or reproduction of any copyright work has been disclosed expressly and sufficiently and the title of the Work and its authorship have been acknowledge in this Work; (4) I do not have any actual knowledge nor do I ought reasonably to know that the making of this work constitutes an infringement of any copyright work; (5) I hereby assign all and every right in the copyright to this work to the University of Malaya (“UM”), who henceforth shall be owner of the copyright in this Work and that any reproduction or use in any form or by any means of whatsoever is prohibited by the written consent of UM having been first hand and obtained; (6) I am fully aware that in the course of making this Work I have infringed any copyright whether intentionally or otherwise, I may be subject to legal action or any other action as may be determined by UM. Candidate’s Signature Date Subscribed and solemnly declared before, Witness’s Signature Date Name: iii ACKNOWLEDGEMENTS I would like to express my deep appreciation and heartfelt thanks to various people. First, I would like to thank my parents, Dr Karuthan Chinna and Dr Krishna Kumari for introducing me to the joy of conducting research and for helping me with the statistical analysis and for meticulously proofreading my work. Next, I want to thank my supervisor Dr Baljit Kaur for going through my work, helping me and guiding me throughout this entire process of writing my thesis. Special thanks to Dr Teoh, Yan, Luna and the other students from the Post-Graduate Club for monitoring my progress and listening to the problems I faced while doing my research. A big thank you to Datin and her team of nurses for participating in this research. Madam Ivy and Madam Rafiah for clarifying and explaining the job-specifications and communication situations, the nurses are involved in. I would like to extend my thanks to my aunty who is a senior nurses for patiently answering my numerous questions about the nursing profession. Thanks to Mahendra and Sumitra, my two siblings for explaining the medical and nursing situations in the hospitals. I would not be able to finish my work if not for the human resource managers who gave me permission to conduct my research and for the nurses who answered my questionnaire and interview sessions. I also take the opportunity to say “thank you” to all those who have contributed in one way or another to make this thesis possible. This study is dedicated to my grandmother, Atah iv Abstract Good English Language communication skills are very important for nurses as they are service providers to patients and deal with doctors, medical support staff and relatives of patients. This study looks at the English language communicative challenges and needs faced by nurses engaged in Medical Tourism in Malaysia. The objectives of this study are to identify: 1) the English Language communicative challenges of these nurses, 2) the English Language communicative needs of these nurses and 3) the language skills required in a proposed English Language curriculum for the nurses. This study uses the concurrent triangulation strategy using quantitative and qualitative approaches to cross validate, corroborate the findings and to complement the weakness and strengths of the two methods (Creswell, 2009). The quantitative section was a questionnaire developed based on instruments used by Basturkmen (2010), O’ Neil (2011) and Wang et al. (2008) and supplemented exploratory interviews with nurses and nursing tutors on communication issues by these nurses. 128 questionnaires from 4 hospitals were collected and analysed using SPSS. In the qualitative section, semi-structured interviews on self-evaluation, problems faced, experiences encountered and recommendations were conducted. Fourteen nurses, two human resource managers, two matrons, two sisters, one clinical instructor participated in the study. Preliminary analysis was based on categories obtained from the quantitative data such as problems encountered, coping strategies and communication situations. The preliminary analysis was then developed into thematic analysis. The results of the first research question revealed that the majority of the nurses especially the new, junior nurses faced problems understanding spoken English and had difficulty speaking in English. Nurses cited different accents, slangs, idiomatic phrases and rapid pace of spoken English made it difficult to understand patients. These nurses’ use of Basic English, at times sounding curt and rude did not aid in building rapport with patients. The findings indicated iii that nurses faced problems in reading and writing nursing documents in English. Often grammar, spelling mistakes, code-switching and use of Manglish were observed. Use of Malay, was common. Interestingly, Malaysian nurses often resorted to getting help from other proficient nurses when encountered with English communication problems. The findings revealed, almost all the nurses wanted to improve their English language skills and were interested in enrolling for a two to three hour class per week. The needs of the nurses include improving general proficiency of the language, focusing on all four skills, grammar and medical vocabulary. From the interviews, recommendations such as being exposed to authentic work–related situations and reviewing previous written reports and appointing a clinical instructor to help new nurses were made. Based on the findings, a three hour, 12 weekly, intermediate course for nurses in the medical tourism sector was developed. The activities in the proposed curriculum are learned-centred as this will allow students to practice, reinforce and explore the language for themselves in work–related situations. The findings of this research have pedagogical implications especially for current nursing programs. iv Abstrak Kemahiran komunikasi Bahasa Inggeris yang baik adalah sangat penting untuk jururawat kerana mereka adalah pembekal perkhimatan kepada pesakit, berurusan dengan doctor, kakitangan sokongan hospital, dan saudara-mara pesakit. Kajian ini melihat cabaran dan keperluan Bahasa Inggeris yang dihadapi oleh jururawat yang terlibat dalam sector pelancongan perubatan di Malaysia. Tujuan penyelidikan ini untuk mengenalpasti adalah 1) cabaran komunikasi Bahasa Inggeris jururawat, 2) keperluan kommunikatif Bahasa Inggeris jururawat dan 3) kemahiran bahasa yang diperlukan dalam sebuah cadangan kurikulum Bahasa Inggeris untuk jururawat. Kajian ini mengunakan strategi triangulasi serentak yang menggunakan pendekatan kuantitatif dan kualitatif untuk mengesahkan, menyokong penemuan serta melengkapi kelemahan dan kekuatan kedua-dua kaedah (Crestwell, 2009). Bahagian kuantitatif, sebuah soal selidik dibangungkan berdasarkan instrument yang diguna oleh Basturkmen (2010), O’ Neil (2011) dan Wang et al. (2008) dan ditambah dengan wawancara jururawat dan pensyarah kejururawatan mengenai isu-isu komunikasi yand dihadapi oleh jururawat Sejumlah 128 soal selidik daripada empat buah hospital telah dikumpul dan dianalisis dengan menggunakan SPSS. Dalam bahagian kualitatif kajian ini, temubual separa berstruktur berkenaan penilaian diri, masalah yang dihadapi, pengalaman yang dihadapi dan cadangan telah dijalankan. Empat belas jururawat, dua pengurus sumber manusia, dua matron, dua “sister”, dan seorang pengajar klinikal telah mengambil bahagian dalam kajian ini. Analisis awal adalah berdasarkan kepada kategori yang diperolehi daripada data kuantitatif seperti masalah yang dihadapi, strategi menghadapi situasi dan situasi komunikasi. Analisis awal kemudiannya telah berkembang menjadi analisis tematik. v Keputusan soalan penyelidikan yang pertama mendedahkan bahawa majoriti daripada jururawat terutamanya yang baru dan junior menghadapi masalah memahami percakapan Bahasa Inggeris dan kesukaran bercakap dalam Bahasa Inggeris. Jururawat menyatakan bahawa pesakit yang mempunyai aksen, slang dan frasa idiomatik yang berbeza serta kadar cepat percakapan Bahasa Inggeris adalah sebab mereka tidak memahami pesakit. Penggunaan asas Bahasa Inggeris oleh jururawat dianggapk kurang sopan dan kasar dan tidak membantu dalam membina hubungan baik dengan pesakit. Dapatan kajan juga menunjukan bahawa para jururawat menghadapi masalah dalam membaca dan menulis dokumen kejururawatan dalam Bahasa Inggeris. Selalunya kesilapan tatabahasa, ejaan, dan pergunaan “code-switching” dan “Manglish” diperhatikan. Penggunaan Bahasa Melayu, adalah lazim. Yang menariknya dapati
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